Ask the Experts

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40 Weeks and Counting

I’m a few days past my due date, and my doctor said I may have to be induced if I don’t deliver soon. Why is this?

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A:

When labor begins on its own, pregnancies are considered full-term anywhere between 37 and 42 weeks. Between 41 and 42 weeks, your pregnancy will be considered post-term, and you may be a candidate for induction because studies show an increased risk of complications then. “Around 42 weeks is when the risk of problems increases,” says certified nurse-midwife Mayri Sagady Leslie, C.N.M., M.S.N., a clinical faculty member at Yale School of Nursing in New Haven, Conn.

Not only might you be at risk of delivering an overly large baby (and, therefore, of having a more difficult vaginal delivery or a Cesarean section), there’s also a chance that your placenta may get old. “The placenta provides the baby with blood, oxygen and nutrients,” Leslie explains. “Once it passes its prime, it doesn’t do its job as well, which means the baby might not do as well.” While “placental insufficiency” typically causes problems such as toolow levels of amniotic fluid, as well as heart-rate problems in the baby, in extreme cases the baby can die in utero (though this is, thankfully, very rare).

When you get to about 41 weeks, your doctor or midwife will likely recommend that you start undergoing regular noninvasive “nonstress” tests to make sure the baby is doing well and having your amniotic fluid level checked with ultrasound. Additionally, she will want to continue the fetal kick counts you began in your third trimester. “If the baby’s heart rate is fine and the tests show that you have plenty of fluid, you still have a healthy pregnancy,” Leslie says, “and there’s no reason to worry about the placenta breaking down.” Before you reach 42 weeks, however, it may be time to consider induction.

Click here to find more articles about labor, c-sections and inducing.